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May 2009 - Traveling with cancer

Traveling With Cancer

At some point in your cancer journey, you will likely have a reason to travel. You may choose to travel for business, pleasure, treatment, or other reasons.

For most people with cancer, air travel is not a problem. However, cancer can sometimes cause physical problems or disabilities that make traveling by plane difficult. Your doctor may recommend that you delay your trip under certain circumstances, such as the following:

You are breathless at rest or with minimal exertion

You are anemic (low red blood cell count)

You are at risk of developing an increased pressure/swelling in the brain due to a brain tumor

You have recently had surgery to the chest, colon, brain, or head and neck region

You have problems with your ears or sinuses

Traveling for Vacation

Many people with cancer want to visit new places they have never been or take a vacation to get their mind off cancer. Although a vacation can help relieve stress, traveling to your destination may actually add to it.

Long lines at the airport and a crowded plane ride can be nerve-wracking for anyone. When you have cancer and you aren’t feeling well, air travel can be even more stressful. You may look for ways to overcome these travel barriers so you can continue to do the things you enjoy.

Traveling for Treatment

You may choose to travel for reasons other than vacation or business, such as for cancer treatment. More and more people with cancer today are seeking treatment far from home. If you decide to travel for cancer treatment, you will likely have some concerns, such as fear of being away from your family. You may also worry about how you will deal with the demands of travel, cancer-related side effects, and the cost of travel. Fortunately, there are organizations that provide help with air fare and accommodations to ease some of the burden of travel costs. Your doctor may also recommend ways to ease side effects during travel.

Improving Your Travel Experience

When you have cancer and you decide to travel, your trip will go much smoother if you plan ahead and take proper precautions. It is important to make travel preparations that will promote your comfort and maintain your safety as much as possible. You can also learn ways to overcome some of your concerns and make traveling easier on yourself.

Tips for Traveling With Cancer

Choose your destination wisely. If you are planning to leave the country, make sure you choose a destination with access to suitable medical care. In some countries, it may be difficult to receive proper care if you need it, and the chances of infection may be greater. Before your trip, find qualified doctors and/or treatment centers in your destination area who can provide care if you need it.

Assess the risks and benefits of travel. When traveling for vacation, make an appointment with your doctor within six weeks before your departure date to discuss your medical condition. Your doctor will make a thorough and realistic assessment of whether or not you are fit to travel. Your doctor may administer tests to determine how well your immune system is functioning and arrange for vaccines and/or preventive medications.

Check your health insurance. Before traveling, check with your health insurance company to determine whether your plan will cover health costs in other states, or if you should visit a certain provider for treatment (if needed). If you are traveling overseas, verify if your health insurance covers costs outside of the United States, or if you need to purchase travel health insurance. You may also want to consider purchasing emergency medical evacuation insurance if you have a medical emergency during the trip.

Prepare ahead for any special travel needs. If you are traveling by plane, make special arrangements at the time of booking. You may request early check-in or boarding, special equipment (e.g., a wheelchair), or a pre-selected seat (e.g., an aisle seat may provide slightly more legroom and give you opportunities to walk around the plane). Also, oxygen levels and air pressure change at high altitudes, so you may need to request supplemental oxygen. Lastly, when checking your baggage, let the airline know if you need assistance to the gate and make sure adequate supplies will be available at your destination.

Get medical documentation from your doctor. Before your trip, contact your doctor to obtain the following:

A letter approving travel. Some airlines require this, particularly if you need special services at the airport.

A general letter detailing your diagnosis and treatment plan, as well as any medical instructions.

Copies of your most recent blood tests and lab test results.

A list of all your medications, including correct dosages and a schedule of when to take them, as well as any drug allergies. Note: If you require injectable medications, or if you are traveling out of the country with certain medications, check restrictions before traveling and bring a letter from your doctor explaining the medication and why you need it.

A recent prescription signed by your doctor in case you need a refill. If you are traveling to a place where your physician is not licensed to prescribe medications, bring a letter from your doctor.

An identification card or written verification for all special medical equipment/devices (e.g., an implanted port, under-the skin pump, tissue expander, syringes). Ask your doctor for a letter describing the type, purpose, and location of the device. Show this information to personnel when passing through security metal detectors.

Keep your medications on hand. Bring with you a sufficient supply of your medications. Carry all your prescription medications with you, not in a suitcase that could get lost or delayed. Keep your medication in the original prescription bottles, which includes your name, medication name, prescription date, pharmacy, and physician's name. Also, have copies of your prescriptions with you in case you lose your medication or your trip gets extended.

Bring important contact information. Keep on hand the contact information of your doctor (e.g., name, address, emergency and office phone numbers), as well as an emergency family contact. If you are traveling abroad, bring the emergency numbers for the cities you will be visiting, as well as the number for the American consulate and/or embassy in your destination country.

Check vaccination requirements (if applicable). If traveling abroad, check the vaccination requirements, as some vaccines needed for entry into certain countries may be contraindicated for cancer patients. For example, certain cancer treatments (e.g., chemotherapy, radiation therapy, steroid therapy) can weaken the immune system and may limit the effectiveness of vaccinations that are required to travel to some parts of the world.

Take early precautions. If you are planning to visit a developing country, your doctor may recommend long-term antibiotic therapy to protect you from a bacterial infection, such as diarrhea. Certain cancer treatments (e.g., radiation therapy) can make the skin highly sensitive to sunlight, so your doctor may recommend ways to protect your skin if you are traveling to a sun-intensive place. If you have anemia and are visiting a high-altitude location, your doctor may prescribe medications or recommend a blood transfusion. Since changes in the air pressure during a flight can trigger lymphedema (swelling in the arms or legs), your doctor may recommend a compression garment to help prevent this condition.

Reduce the risk of blood clots. Airline travelers on long flights have a higher risk of developing blood clots, as do people with certain types of cancer (e.g., lung, stomach, or bowel cancer) or those who have undergone certain cancer treatments. To help prevent blood clots, wear comfortable clothing and shoes and perform gentle arm and leg exercises during the trip. If you will be sitting for a long time, get up and walk around once every hour to increase circulation. Your doctor may also recommend taking aspirin or other medications to thin the blood before your flight.

Minimize chance of infection. Try to avoid infections and injury while traveling, which can strain your immune system. Wash your hands often and use hand sanitizers or wipes, particularly before eating and touching your face, eyes, nose, and mouth. Drink only bottled water and eat only hot, well-cooked foods. Be careful of unwashed food or food that has been sitting out. Also, avoid raw or undercooked foods, unpasteurized dairy products, and deli meats.

Bring snacks and light meals. Eating a well-balanced diet can be difficult when traveling, especially if you are dealing with side effects like nausea or loss of appetite. However, eating small, frequent meals can help improve your energy and overall well being. You may want to bring along meal-replacement drinks or snacks (e.g., peanut-butter, crackers, nuts, energy bars). In addition, it is important to stay hydrated, especially when on a plane, and avoid drinking alcoholic beverages.

Know your body's limits. Cancer and its treatment can make you feel tired or weak, and traveling can add to your fatigue. It is important to know and respect your body’s limits and don’t overschedule your trip. Make sure you allow yourself enough travel time to get to your destination without rushing. At your destination, schedule regular rest periods to save your energy and reduce fatigue. Also, try to find ways to manage your stress.

Pick a good travel companion. When you have cancer, you often rely on others for help. Although it may be frustrating to depend on others, it is important you have extra support when traveling. It is always a good idea to travel with someone whose company you enjoy. You should also choose a person you feel comfortable helping you if you need assistance.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING TRAVELING WITH CANCER.